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Government warns churches against ‘reckless confidence’ over COVID-19

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Boss Mustapha


• Experts harp on risk factors, case fatality ratio
• Explain why Nigeria, Ghana, others may record lower deaths

The Federal Government yesterday warned churches to stop what the Chairman of the Presidential Taskforce on COVID-19 and Secretary to the Government of the Federation, Boss Mustapha, described as “exhibition of reckless confidence” regarding immunity to the Coronavirus disease. Mustapha, who gave the warning yesterday during the Interdenominational Church Prayer Service organised by the Nigerian Interreligious Council (NIREC) in Abuja, urged church leaders to tell their congregations to “stay safe for themselves, their families and for the body of Christ”

The SGF observed that the Coronavirus disease had come with all forms of uncertainties and there had not been any established protocol for treatment. He said that non-pharmaceutical interventions had remained the most effective tool for countries to overcome the pandemic. He noted that there was no known vaccine or cure in sight, stressing that COVID-19 had come to stay, even as scientists involved in the research for a solution had given between 18 and 24 months as time frame for likely vaccine solution. 

“You can see that this virus has confounded and confused the entire world; it has brought the democracies and economies that existed for the last 300 years on their knees; it has overwhelmed them, and what makes you think that it cannot overwhelm us?  The Church should stop the exhibition of reckless confidence and tell their congregations to do the proper thing which is, stay safe for themselves, their families and for the body of Christ,” he said.

 
“For the good of yourself and your family is to adhere to non-pharmaceutical measures and protect yourself against the Coronavirus disease. Stay at home, maintain physical distancing, wear a facemask, because the virus is emitted either through sneezing or coughing; ensure personal hygiene.”

Mustapha noted that the positive intervention of the Christian Association of Nigeria (CAN) and the Nigerian Supreme Council for Islamic Affairs (NSCIA) is what the adherents of the two major religions needed to do more often. He urged Christians and to always seek areas of collaboration to promote social harmony, progress and peaceful co-existence. 

Federal Government’s warning came on the heels of latest figures from the World Health Organisation (WHO) suggesting that sub-Saharan African countries had the least number of confirmed coronavirus disease (COVID-19) deaths and case fatality ratio (CFR) in the world.

CFR, sometimes called case fatality risk or case fatality rate, is a measure of the severity of a disease: the proportion of deaths from a certain disease compared to the total number of people diagnosed with the ailment within a timeframe.

Why are African countries recording the least number of confirmed COVID-19 deaths? The reasons have divided medical experts. Some say the continent is merely lucky, has not tested enough people, is under-reporting cases and deaths, and has a younger population than other continents. Others argue that sub-Saharan countries are protected because of their high humidity and temperature, and exposure to tuberculosis vaccine, Bacille Calmette-Guerin (BCG).

Others, yet, point out that WHO’s World Health Statistics indicate Nigeria and many African countries have low average life expectancy, and that those most vulnerable to COVID-19 (elderly, cancer patients, people living with diabetes, asthma, hypertension) passed away before the virus struck. In Nigeria, less than 20 per cent of the population is over 50 years of age.

Excluding South Africa with 187,977 cases and 3,026 deaths (CFR- 1.60 per cent), Egypt with 74,035 cases and 3,280 deaths (CFR- 4.43 per cent), and Algeria with 15,500 cases and 946 deaths (CFR- 6.10 per cent), no other country on the continent, as at July 5, has had up to 600 deaths.

According to WHO’s data on countries, territories or areas with reported laboratory-confirmed COVID-19 cases and deaths, Nigeria has the highest number of incidents and deaths with 28,167 and 634 respectively (CFR- 2.25 per cent). Nigeria is closely followed by Ghana with 19,388 cases and 117 deaths (CFR- 0.60 per cent); Cameroon with 12,592 cases and 313 deaths (CFR- 2.48 per cent); Côte d’Ivoire with 10,244 cases and 70 deaths (CFR- 0.68 per cent); Democratic Republic of the Congo with 7,373 cases and 181 deaths (CFR- 2.45 per cent); and Senegal with 7,272 cases and 129 deaths (CFR- 1.77 per cent).

According to WHO, African countries including South Africa and Algeria, but excluding Egypt, have 356,666 cases and 6,746 deaths (CFR- 1.89 per cent) out of the 11,125,245 cases and 528,204 deaths (CFR- 4.74 per cent) globally.

The Americas has the highest number of cases and deaths with 5,697,954 cases cases and 262,538 deaths (CFR- 4.6 per cent). It is closely followed by Europe with 2,774,221 cases and 199,879 deaths (CFR- 7.2 per cent); Eastern Mediterranean with 1,153,157 cases and 27,074 deaths (CFR- 2.34 per cent); South-East Asia with 918,59 cases and 24,473 deaths (CFR- 2.66 per cent); and Western Pacific with 223,915 cases and 7,481 deaths (CFR- 3.34 per cent).

The United States with 2,776,366 cases and 129,226 deaths (CFR- 4.65 per cent) and Brazil with 1,539,081 cases and 63,174 deaths (CFR- 4.1 per cent) have the highest number of cases and deaths in the world but the United Kingdom with 284,908 cases and 44,198 deaths has the highest CFR of 15.51 per cent.

A consultant public health physician and Executive Director of Enugu State Agency for the Control of AIDS (ENSACA), Dr. Chinedu Arthur Idoko, told The Guardian: “Indeed, African countries have been recording the least COVID-19 deaths. However, whether this is, in reality, a true reflection of the actual COVID-19 deaths or probably due to un-captured COVID-19 related deaths (as a result of not testing enough) is yet to be practically ascertained.

“I think it might be due to the number tested, which is not as much as that of other continents of the world. The consequence is that there are COVID-19 deaths, which may not have been appropriately captured because diagnosis was not even made in the first place.

“Another way of looking at it is that there seems to be something about sub-Saharan Africa that is resulting in less severe presentations of the disease, and hence, less deaths. Maybe, it is some form of cross immunity conferred from other commonly prevalent and endemic diseases we suffer and recover from, here. Who knows?”

A pharmacist and founder/publisher of Pharma News, Sir Ifeanyi Atueyi, said African countries are recording the least COVID-19 deaths because the “hot tropical temperature is not conducive to the survival of the coronavirus, and high humidity may slow down the transmission of the virus by reducing the distance it can travel in the air.

“The genes of Africans may be a contributory factor tempering the severity of the infection. The immune system in the tropics may be more resistant to the coronavirus because of exposure to some endemic diseases like malaria.

“Nutritional factors are very important. Africans eat more natural and fresh plant products such as vegetables and fruits. Advanced countries consume a lot of food preserved with chemicals some of which may be dangerous. Advanced countries eat a lot of meat, fats and oils, flour products, sugar and salt-rich foods, which are unhealthy.

“Limitations in documentation have been a problem in developing countries. Scientific facts cannot be fully established without accurate figures. Deliberate cover-ups have been observed in certain areas in Nigeria. For instance, hundreds of people died in Kano State within a short period and were hurriedly buried. No post mortem examination was carried out. Kogi State resisted the entry of the Nigerian Centre for Disease Control (NCDC) into the state. In Cross River State, there are controversial statements.

“Inadequacy of testing facilities makes diagnosis of coronavirus difficult. The more people are tested, the more the cases. The BCG vaccination policy in countries like Nigeria is helping to contain the virus according to survey.”

A public health physician and former Executive Director/Chief Executive Officer (CEO) of the National Primary Health Care Development Agency (NPHCDA), Dr. Ado Jimada Gana Muhammad, said: “More than 60 per cent of the African population are under the age of 25, making it the continent with the youngest population.

“According to Dr. Matshidiso Moeti, WHO Regional Director for Africa, ‘it is possible our youth dividend is paying off and leading to fewer deaths. Elderly and older adults have a significantly increased risk of developing a severe illness. In Europe, nearly 95 per cent of deaths occurred in those older than 60 years’.”

Muhammad said the low prevalence of non-communicable diseases (NCDs) in Africa is a big factor. “This puts Africa at an advantage since elderly and older adults and those with underlying NCDs such as diabetes, cardiovascular disease, cancers and chronic respiratory disease are at higher risk of developing serious illness and deaths from complications,” he said.

The public health physician also said there is under-reporting of mortalities. He noted that the numbers being reported are not reliable indicators of the spread and severity of the outbreak in Africa. He said available data indicates that all but seven African countries have yet to reach the 1,000 per million test mark as of May 4, with more than half registering testing rates below 500 people per million.

He said stigma might explain non-reporting of suspected cases and mortalities to health facilities. Cross-reacting antibodies may also be a reason. According to him, prior exposure to infections and vaccination might give people some level of antibodies.

A consultant pharmacognocist and President, Bioresources Development Group, Prof. Maurice Iwu, agreed that Africans might have some form of protection from the coronavirus.
“An issue is high humidity in most African countries, not just hot temperatures. Because of the density of the virus in tropical Africa, it cannot travel far. That means the recommendation of two metres of social distancing may not apply here because the virus cannot go far.”

Iwu also raised the diet factor. “Our food has more antioxidants. We take a lot of phytomedicines. A lot of our diets contain zinc, vitamin C and other antioxidants. People take all these on a daily basis without even thinking about it,” he said.

There is also the social exclusion of Sub-Saharan Africa. He explained: “We are excluded from so many socio-economic activities going on in the West. The number of people who travel from Milan to New York on a daily basis far outnumbers the air travels in most parts of Africa. So, the socio-economic exclusion from the global picture has protected us from the quick spread of the virus through frequent business travels and inter-continental movements.”

Iwu further cited the issue of seasonal flu vaccines common in most European and American countries. “Most of these countries use flu vaccine. Once you take the flu vaccine and a new strain comes in, it will cause all the defence mechanisms to relax. This scenario makes most countries that use the flu vaccine more vulnerable to COVID-19,” he said.

Indeed, a recent study published by Chinese researchers from Beihang University (BUAA) and the Institute of Economics, School of Social Sciences, Tsinghua University, demonstrated how high temperature and high humidity reduce the transmission of COVID-19.

The study was published in the journal SSRN. The researchers explained: “The paper investigated the influence of air temperature and relative humidity on the transmission of COVID-19. After estimating the serial interval of COVID-19 from 105 hand-collected pairs of the virus carrier and the infected, we calculate the daily effective reproductive number, R, for each of all 100 Chinese cities with more than 40 cases. Using the daily R-values from January 21 to 23, 2020 as proxies of non-intervened transmission intensity, we find, under a linear regression framework, high temperature and high humidity significantly reduce the transmission of COVID-19, respectively. One-degree Celsius increase in temperature and one per cent increase in relative humidity lower R by 0.0225 and 0.0158, respectively.

“This result is consistent with the fact that the high temperature and high humidity reduce the transmission of influenza and Severe Acute Respiratory Syndrome (SARS). It indicates that the arrival of summer and rainy season in the northern hemisphere can effectively reduce the transmission of COVID-19.”

Also, The Guardian investigation revealed that most countries in malaria endemic regions/Sub-Saharan African nations have lower cases and deaths from COVID-19. According to the WHO Malaria Map and COVID-19 Map, most countries in Sub-Saharan Africa are endemic to malaria and are equally least affected by the coronavirus.

In 2018, six countries accounted for more than half of all malaria cases worldwide: Nigeria (25 per cent), the Democratic Republic of the Congo (12 per cent), Uganda (five per cent), and Côte d’Ivoire, Mozambique and Niger (four per cent each).

The WHO Malaria Map shows that more than 90 per cent of countries worst hit by COVID-19 are not endemic to malaria including France, United States, United Kingdom, Canada, Spain, Italy, and Iran among others.

Unconfirmed report suggests that no sickle cell anaemia patient has died of COVID-19 because they are invulnerable to malaria. Africa is endemic to sickle cell anaemia. In fact, more than 90 per cent of all sickle cell anaemia cases exist on the continent.

A consultant public health physician and leader of the team of medical experts managing some of the COVID-19 isolation centres in Lagos, Prof. Akin Osibogun, told The Guardian that although he could not confirm the malaria-COVID-19 map claim, it was logical and worth investigating.

“No study has looked at that. Although it sounds logical but there is no scientific backing. What I think might explain why more black people in the United States and United Kingdom are dying from COVID-19 is because of the historical social inequalities that exist between whites and blacks in those societies. Whites are more likely to have health insurance and more likely to get urgent attention for ambulance service. Another argument is that the BCG vaccination, which most Africans had, maybe offering some protection.”

Meanwhile, a new study published June 24, 2020, by researchers from Nigeria, United Kingdom (U.K.) and United States (U.S.) concluded that countries with robust BCG vaccination policy had lower case fatality of COVID-19.

BCG is one of the routine vaccines given to newborn babies in Nigeria to protect against tuberculosis. The study, published in the Journal of Infectious Diseases and Epidemiology, is titled ‘A Multi-country Level Comparison of BCG Vaccination Policy and COVID-19 Cases and Mortality’.


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